School School Nur Nursing: g: Sc Scope ope and and Standar St - PDF document

Measures have been taken, by the Utah Department of Health, Bureau of Health Promotions, to ensure no conflict of interest in this activity School School Nur Nursing: g: Sc Scope ope and and Standar St andards of of Pr Practice CATHERINE SPARKS, MSN, RN, NCSN STATE SCHOOL NURSE CONSULTANT JUNE 2014 1902 Lina Rogers First US School Nurse The School Nurse: A Survey of the Duties and Responsibilities of the Nurse in Maintenance of Health and Physical Perfection and the Prevention of Disease Among School Children. View online via Google Books 1

Objectives In this session, we will:  Determine Scope of Practice  Determine purpose and importance of Scope and Standards to School Nurse Practice  Examine the Standard Statements and their meaning  Discuss use of Standards in guiding School Nurse evaluation Scope and Standards of Practice SCOPE describes the who, what, where, when, why and how of school nursing STANDARDS , guide our role implementation, interpretation and evaluation SCOPE (ANA) ANA, President Daley, speaks at NASN 2011 On Scope of School Nurse Practice http://www.nursingworld.org/ScopeofPractic e Model of Professional Nursing Practice Regulation 2

Definition of School Nursing School nursing is a specialized practice of professional nursing that advances the well ‐ being, academic success and life ‐ long achievement and health of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self ‐ management, self advocacy, and learning (NASN, 2010) SCOPE defined by Roles of the School Nurse 1. Facilitate normal development and positive student response to intervention. 2. Provides leadership in promoting health and safety, including a healthy environment. 3. Provides quality health care and intervenes with actual and potential health problems. 4. Utilizes clinical judgment in providing case management services. 5. Collaborates with others to build student and family capacity for adaptation, self ‐ management, self advocacy and learning. What does a School Nurse do? Wh Committees Broken bones Broken Hearts physicians Mental Health EDUCATE Teen Relationships Hand Washing Teacher with cancer COMMUNICATION the cutter Ethics STAFF TRAINING Disease Outbreak Death of a student Local Health Departments Grieving Substance abuse PARENTS Cultural Competency Eating Disorders Self ‐ efficacy Independence Teen Pregnancy CARE Life choices Expert Leader sexually transmitted infections LOVE WHAT THEY DO USE CRITICAL THINKING SKILLS EVERY DAY 3

Primary Goal of the School Nurse is to support student learning. This is accomplished by implementing strategies that promote student and staff health and safety. SCOPE Roles of the school nurse continuously expanding The depth and breadth in which individual school nurses engage in the total scope of school nursing practice depend on education, experience, role, work environment, and the population served. School Nursing: Scope and Standards of Practice, 2 nd edition SCOPE is determined by School Nurse to Student Ratio or Acuity? American Academy of Pediatrics ◦ One school nurse per every school building National Association of School Nurses ◦ 1 school nurse per every 750 students ◦ 1 school nurse per every 250 students with special health care needs ◦ 1 school nurse per every 1 student with complex and unpredictable health care needs 4

ECBP ‐ 5 Increase the proportion of elementary, middle, and senior high schools that have a full ‐ time registered school nurse ‐ to ‐ student ratio of at least 1:750 HTTP://WWW.CDC.GOV/HEALTHYYOUTH/PROFILES/INDEX.HTM HTTP://HEALTHYPEOPLE.GOV/2020/TOPICSOBJE HTTP://WWW.CDC.GOV/HEALTHYYOUTH/SHPPS/INDEX.HTM CTIVES2020/OBJECTIVESLIST.ASPX?TOPICID=11 Utah (average) School Nurse to Student Ratio 2013 Public school student population 61,2551 Total FTE of around 200 school nurses 142 Utah best overall estimate school nurse to student ratio 1:4314 Disclaimer: this ratio is not equally distributed between districts or charter schools for some districts have ratios as high as 1:6700 and some as low as 1:<1000 SCOPE The school nurse is responsible for all students in a given school, district or region The school nurse is most likely the only health care provider in the educational setting  This does not give the school nurse any authority in performing medical diagnosis 5

SCOPE is legally determined by level of professional practice  Licensed Practical Nurses (LPN) – 1 year of training ◦ Licensed to practice under the supervision of a registered nurse or physician ◦ Cannot delegate tasks to others. ◦ Cannot initiate teaching with students or staff.  Emergency Medical Technicians ‐ (140 ‐ 1200 hours) ◦ Licensed to practice under supervision of a physician or emergency protocols. ◦ Limited pediatric training Neither can make nursing assessments nor practice registered nursing without a license. Recommended School Nurse Credentials Leadership  School nurse supervisors and administrators  Lead nurses  Team leaders  Advanced practice RN NCSN information found at:  School nurse http://www.nasn.org/rolecareer/ schoolnursecertification consultants http://www.nbcsn.org/ Writing your name and credentials Highest earned degree, mandated requirements (i.e. licensure), state designations or requirements, national certifications, awards and honors, other certifications. Mary B. Smith, BSN, RN, CCRN Beth Mattey, MSN, RN, NCSN Terri Lipman, PhD, CRNP, FAAN www.wocn.org/resource/resmgr/.../ana_credentials _for_the_prof.pdf 6

E ‐ mail signature Your name, credentials Job title Contact information ********** IMPORTANT MESSAGE ********** This message, including any attachments, may contain confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, delete this message, including from trash, and notify me by telephone or email. If you are not the intended recipient, any distribution or copying of this message, or the taking of any action based on its content is strictly prohibited Standards of School Nurse Practice  Standards are best used as broad professional expectations that reflect the values and priorities of the discipline (ANA, 2004)  Are established by a professional organization for specialty practice  Are an agreed ‐ on level of practice developed to characterize and guide the nurse in achieving Excellence in school nursing practice  Legal statutes to guide School Nurse Practice  When tailored to fit a specific area of school nursing, provide a means for evaluation by describing competent levels of practice Standards of School Nurse Practice 17 Standards divided between Two categories:  Standards of Practice (6)  Standards of Professional Performance (11) 7

Standards of Practice The first six standards encompass the Nursing Process 1. Assessment 2. Diagnosis 3. Outcomes Identification 4. Planning 5. Implementation 6. Evaluation Use of standards in developing an evaluation tool http://www.nasn.org/Portals/0/positions/2013pssupervision.pdf 8

Standards: developing an evaluation tool Standards of Professional Performance 7: Ethics 13: Collaboration 8: Education 14: Professional Practice Evaluation 9: Evidence ‐ Based Practice and Research 15: Resource Utilization 10: Quality of Practice 16: Environmental Health 11: Communication 17: Program Management 12: Leadership 7. Ethics: The school nurse practices ethically.  Legal requirement to be an advocate for your students (clients)  Putting the client and family before oneself or one’s employer  Follows the nursing code of ethics for nurses with interpretive statements for the school nurse (NASN, 2010)  Care is delivered in a manner that protects client autonomy, dignity, and rights, and confidentiality  Professional role boundaries , nurse ‐ client relationships are maintained 9

Evaluating Ethics (CO) http://www.cde.state.co.us/sites/default/files/2013 ‐ 09 ‐ 15%20Nurse%20Rubric.pdf 8. Education: The school nurse attains knowledge and competency that reflects current nursing practice.  School nurses have the responsibility for keeping themselves current  Involve oneself in local, state and national school nursing organizations  Keep an awareness that you are a medical professional working in an educational setting where student health is not a main priority 9: Evidence ‐ Based Practice and Research: The school nurse integrates evidence and research findings into practice “ nursing actions are based on sound theory and research” (Adams, 2009) Case studies Expert opinions Scientifically collected data that has been analyzed (Adams & McCarthy, 2007) 10

North Carolina: School Nurse Evaluation Process http://ncees.ncdpi.wikispaces.ne t/file/view/School%20Nurses%20 Eval%20Users%20Guide.pdf/441 364212/School%20Nurses%20Ev al%20Users%20Guide.pdf 10: Quality of Practice: The school nurse contributes to quality of nursing practice. The school nurse must monitor and critically evaluate the effectiveness of individual nurse practice and the whole of the school health program This standard is usually coupled with Standard 17: Program Management Ohio Association of School Nurses SCHOOL NURSE EVALUATION SYSTEM (OASN/SNES) http://www.oasn. org/files/resource smodule/5269948 3011a1/OASN_SN ES_11_9_13.pdf 11